Rapid urbanization in low- and middle-income countries (LMICs) has deepened health inequities and increased pressure on already under-resourced urban infrastructures and services. This is critical in LMICs which face a growing health crisis of non-communicable diseases (NCDs) such as cardiovascular diseases, with almost 75% of the global NCD deaths occurring in LMICs.
The Novartis Foundation is taking ambitious steps to tackle hypertension, the prime risk factor for cardiovascular disease, in low-income urban communities. Better Hearts Better Cities convenes multisector partners - from food suppliers to health authorities, employers and city planners - to contribute expertise and resources for local solutions that improve cardiovascular health in cities.
The innovative approach is being tested in three cities, Ulaanbaatar, Mongolia, Dakar, Senegal, and a city in Brazil to be announced later this year.
"To thrive, cities must become ecosystems of health and wellbeing, where each part works toward the same goal of improving people's quality of life. No single actor can tackle hypertension alone and multisector innovation is needed. This is the driving force behind Better Hearts Better Cities. We plan to create a network of partners to co-design, implement and evaluate interventions that strengthen urban health systems while seeking to innovate the way prevention and care is provided," said Ann Aerts, Head of the Novartis Foundation.
"Cities in LMICs can be made healthier places only through close collaboration, with clear benefits to be gained by employers, governments and communities alike in taking joint action to support a healthy workforce" said Katie Dain, Executive Director of the NCD Alliance, the initiative's global NCD advocacy and workplace partner. "Our priority is to strengthen NCD prevention and control by uniting and strengthening the civil society networks in low-income urban areas to stimulate advocacy, action and accountability."
Information and communication technology (ICT), or digital technology, is an integral part of Better Hearts Better Cities. Intel Corporation, as digital advisor for this initiative, provides in-kind support by performing ICT assessments in the three cities. Intel plans to utilize the insights together with the other partners to design a more sustainable health system that incorporates next generation technology infrastructure alongside improvements in care delivery. "The affordability constraints and lack of existing healthcare infrastructure in LMICs actually represent a great opportunity to leapfrog over mature markets, because we can bypass costly development stages that are just not realistic there," said Jennifer Esposito, General Manager, Global Health and Life Sciences at Intel Corporation. "We're excited to apply our technology expertise and collaborate on novel approaches that help deliver care at significantly lower costs while improving access and increasing quality."
Progress in Ulaanbaatar
Implementation of the initiative is most advanced in Ulaanbaatar, the capital of Mongolia and home to half of the country's population, around 1.4 million people. In this capital city, also one of the world's most polluted cities, more than 25% of the population suffer from hypertension and cardiovascular disease is the leading cause of death, accounting for over 40% of the annual deaths. Better Hearts Better Cities partners, including Onom Foundation, Ulaanbaatar City Municipal Government and Health Department, National Insurance Fund and the Mongolian Chamber of Commerce, seek to address determining factors such as high salt consumption and poor diet, and are co-developing and implementing a first wave of interventions to improve quality and efficiency of care as well as health literacy.
About the Novartis Foundation
The Novartis Foundation is a philanthropic organization which strives to have sustainable impact on the health of low-income communities through a combination of programmatic work, health outcomes research, and its translation into policy to tackle global health challenges. We work hand-in-hand with local and global partners to catalyze sustainable healthcare models to improve access and health outcomes, and to accelerate efforts to eliminate leprosy and malaria by focusing on interventions that aim to interrupt transmission. Everything we do is grounded in evidence and innovation, and our work is a continuous cycle of evaluation, adaptation and application. In 2016, the operational budget for the Foundation was CHF 15 million and our programs reached 8.9 million people.
1. World Health Organization, Global status report on non-communicable diseases, 2014, [p.xi]
2. Mongolian Statistical Information Service. 2015. Available at http://www.1212.mn/statHtml/statHtml.do?orgId=976&tblId=DT_NSO_0300_004V1&conn_path=I2&language=en
3 WHO Global Health Observatory - City Level Exposure 2016. Available at http://apps.who.int/gho/data/view.main.AMBIENTCITY2016?lang=en
4 World Health Organization. STEPS Survey Mongolia. 2013
5. Institute for Health Metrics and Evaluation, 2015. Available at http://www.healthdata.org/mongolia
6. WHO. Salt reduction in Mongolia. Available at http://www.wpro.who.int/world_health_day/2013/measuring_and_reducing_salt_MNG.pdf?ua=1